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Int J Environ Res Public Health. 2018 Aug 7;15(8). pii: E1682. doi: 10.3390/ijerph15081682.

Do Water, Sanitation and Hygiene Conditions in Primary Schools Consistently Support Schoolgirls' Menstrual Needs? A Longitudinal Study in Rural Western Kenya.

Author information

1
Liverpool School of Tropical Medicine, Liverpool L35QA, UK. Kelly.Alexander@care.org.
2
Cooperative for Assistance and Relief Everywhere (CARE), 151 Ellis St NE, Atlanta, GA 30303, USA. Kelly.Alexander@care.org.
3
Liverpool School of Tropical Medicine, Liverpool L35QA, UK. Garazi.Zulaika@lstmed.ac.uk.
4
Kenya Medical Research Institute, Kisumu 1578-40100, Kenya. ENyothach@kemricdc.org.
5
Kenya Medical Research Institute, Kisumu 1578-40100, Kenya. oduor.clifford@gmail.com.
6
Liverpool School of Tropical Medicine, Liverpool L35QA, UK. Linda.Mason@lstmed.ac.uk.
7
Kenya Medical Research Institute, Kisumu 1578-40100, Kenya. DObor@kemricdc.org.
8
Safe Water and AIDS Programme, Kisumu 3323-40100, Kenya. alie@swapkenya.org.
9
Kenya Medical Research Institute, Kisumu 1578-40100, Kenya. kel4@cdc.gov.
10
Centers for Disease Control and Prevention, Atlanta, GA 30333, USA. kel4@cdc.gov.
11
Liverpool School of Tropical Medicine, Liverpool L35QA, UK. Penelope.Phillips-Howard@lstmed.ac.uk.

Abstract

Many females lack access to water, privacy and basic sanitation-felt acutely when menstruating. Water, sanitation and hygiene (WASH) conditions in schools, such as access to latrines, water, and soap, are essential for the comfort, equity, and dignity of menstruating girls. Our study was nested within a cluster randomized controlled pilot feasibility study where nurses provided menstrual items to schoolgirls. We observed the WASH conditions of 30 schools from June 2012⁻October 2013 to see if there were any changes in conditions, to compare differences between study arms and to examine agreement between observed and teacher-reported conditions. Data came from study staff observed, and school head teacher reported, WASH conditions. We developed scores for the condition of school facilities to report any changes in conditions and compare outcomes across study arms. Results demonstrated that soap availability for students increased significantly between baseline and follow-up while there was a significant decrease in the number of "acceptable" latrines. During the study follow-up period, individual WASH indicators supporting menstruating girls, such as locks on latrine doors or water availability in latrines did not significantly improve. Advances in WASH conditions for all students, and menstrual hygiene facilities for schoolgirls, needs further support, a defined budget, and regular monitoring of WASH facilities to maintain standards.

KEYWORDS:

Kenya; MHM (menstrual hygiene management); girls; hygiene; menstruation; rural; sanitation; schools; water

PMID:
30087298
PMCID:
PMC6121484
DOI:
10.3390/ijerph15081682
[Indexed for MEDLINE]
Free PMC Article

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